Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)
Purpose To assess the functional Queryoutcome of patients with cystoscopic recurrence of stricture post-urethroplasty and to evaluate the role of cystoscopy as initial screening tool to predict future failure. Methods Cases with cystoscopy data after anterior urethroplasty in a multi-institutional d...
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Veröffentlicht in: | World journal of urology 2019-12, Vol.37 (12), p.2763-2768 |
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creator | Baradaran, Nima Fergus, Kirkpatrick B. Moses, Rachel A. Patel, Darshan P. Gaither, Thomas W. Voelzke, Bryan B. Smith, Thomas G. Erickson, Bradley A. Elliott, Sean P. Alsikafi, Nejd F. Vanni, Alex J. Buckley, Jill Zhao, Lee C. Myers, Jeremy B. Breyer, Benjamin N. |
description | Purpose
To assess the functional Queryoutcome of patients with cystoscopic recurrence of stricture post-urethroplasty and to evaluate the role of cystoscopy as initial screening tool to predict future failure.
Methods
Cases with cystoscopy data after anterior urethroplasty in a multi-institutional database were retrospectively studied. Based on cystoscopic evaluation, performed within 3-months post-urethroplasty, patients were categorized as small-caliber (SC) stricture recurrence: stricture unable to be passed by standard cystoscope, large-caliber (LC) stricture accommodating a cystoscope, and no recurrence. We assessed the cumulative probability of intervention and the quality of life scores in association with cystoscopic recurrence 1-year post-urethroplasty. Patients with history of hypospadias, perineal urethrostomy, urethral fistula, and meatal pathology were excluded.
Results
From a total of 2630 men in our cohort, 1054 patients met the inclusion criteria: normal (
n
= 740), LC recurrence (
n
= 178), and SC recurrence (
n
= 136) based on the first cystoscopic evaluation performed at median 111 days postoperatively. Median follow-up was 350 days (IQR 121–617) after urethroplasty. Cystoscopic recurrence was significantly associated with secondary interventions (2.7%, 6.2%, 33.8% in normal, LC, and SC groups, respectively). Quality of life variables were not statistically significantly different among the three study groups.
Conclusions
Many patients with cystoscopic recurrence do not need an intervention after initial urethroplasty. Despite good negative predictive value, cystoscopy alone may be a poor screening test for stricture recurrence defined by patient symptoms and need for secondary interventions. |
doi_str_mv | 10.1007/s00345-019-02653-6 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2179530732</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2174915620</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-456474a443e605d48628c376c66cdbab85cc1a764d94c53bcad86dd0017174253</originalsourceid><addsrcrecordid>eNp9kU1vEzEQhi0EoqHwBzggS1zKYcFfa-9yqyK-pKpIbXJeObPe4LK7DmMblJ_HP8NpAkgcuNgez_PO2PMS8pyz15wx8yYyJlVdMd5WTOhaVvoBWXAlZdUYoR-SBTNCVapt5Bl5EuMdY9xoVj8mZ5IZLljLF-TncvSzBzvS6LezH8pxBkfDQGEfU4gQdh5oRpe-4AFK6CGVkKKDjOgOsB2SQ2rnsvqAJzjsRhvT_i21dMpj8pWfY_IpJx_mwtpxH32kA4aJrtDmyZbLnq4xjGFbOt44CEWAGZL_7ui1Sz8Cfj286zbj1pUcvVitb65vXz0ljwY7RvfstJ-T9ft3q-XH6urzh0_Ly6sKFG9TpWqtjLJKSVdm0KtGiwak0aA19Bu7aWoAbo1WfauglhuwfaP7_jAzbpSo5Tm5ONbdYfiWXUzd5CO4cbSzCzl2gpu2LoOVoqAv_0HvQsby53tKtbzWghVKHCnAECO6oduhnyzuO866g8Hd0eCuGNzdG9zpInpxKp03k-v_SH47WgB5BGJJzVuHf3v_p-wv8dy1UQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2174915620</pqid></control><display><type>article</type><title>Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Baradaran, Nima ; Fergus, Kirkpatrick B. ; Moses, Rachel A. ; Patel, Darshan P. ; Gaither, Thomas W. ; Voelzke, Bryan B. ; Smith, Thomas G. ; Erickson, Bradley A. ; Elliott, Sean P. ; Alsikafi, Nejd F. ; Vanni, Alex J. ; Buckley, Jill ; Zhao, Lee C. ; Myers, Jeremy B. ; Breyer, Benjamin N.</creator><creatorcontrib>Baradaran, Nima ; Fergus, Kirkpatrick B. ; Moses, Rachel A. ; Patel, Darshan P. ; Gaither, Thomas W. ; Voelzke, Bryan B. ; Smith, Thomas G. ; Erickson, Bradley A. ; Elliott, Sean P. ; Alsikafi, Nejd F. ; Vanni, Alex J. ; Buckley, Jill ; Zhao, Lee C. ; Myers, Jeremy B. ; Breyer, Benjamin N.</creatorcontrib><description>Purpose
To assess the functional Queryoutcome of patients with cystoscopic recurrence of stricture post-urethroplasty and to evaluate the role of cystoscopy as initial screening tool to predict future failure.
Methods
Cases with cystoscopy data after anterior urethroplasty in a multi-institutional database were retrospectively studied. Based on cystoscopic evaluation, performed within 3-months post-urethroplasty, patients were categorized as small-caliber (SC) stricture recurrence: stricture unable to be passed by standard cystoscope, large-caliber (LC) stricture accommodating a cystoscope, and no recurrence. We assessed the cumulative probability of intervention and the quality of life scores in association with cystoscopic recurrence 1-year post-urethroplasty. Patients with history of hypospadias, perineal urethrostomy, urethral fistula, and meatal pathology were excluded.
Results
From a total of 2630 men in our cohort, 1054 patients met the inclusion criteria: normal (
n
= 740), LC recurrence (
n
= 178), and SC recurrence (
n
= 136) based on the first cystoscopic evaluation performed at median 111 days postoperatively. Median follow-up was 350 days (IQR 121–617) after urethroplasty. Cystoscopic recurrence was significantly associated with secondary interventions (2.7%, 6.2%, 33.8% in normal, LC, and SC groups, respectively). Quality of life variables were not statistically significantly different among the three study groups.
Conclusions
Many patients with cystoscopic recurrence do not need an intervention after initial urethroplasty. Despite good negative predictive value, cystoscopy alone may be a poor screening test for stricture recurrence defined by patient symptoms and need for secondary interventions.</description><identifier>ISSN: 0724-4983</identifier><identifier>EISSN: 1433-8726</identifier><identifier>DOI: 10.1007/s00345-019-02653-6</identifier><identifier>PMID: 30712091</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Clinical significance ; Cystoscopy ; Fistulae ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nephrology ; Oncology ; Original Article ; Quality of life ; Recurrence ; Retrospective Studies ; Self report ; Stricture ; Trauma ; Urethra - surgery ; Urethral Stricture - surgery ; Urologic Surgical Procedures, Male - methods ; Urology</subject><ispartof>World journal of urology, 2019-12, Vol.37 (12), p.2763-2768</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>World Journal of Urology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-456474a443e605d48628c376c66cdbab85cc1a764d94c53bcad86dd0017174253</citedby><cites>FETCH-LOGICAL-c419t-456474a443e605d48628c376c66cdbab85cc1a764d94c53bcad86dd0017174253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00345-019-02653-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00345-019-02653-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30712091$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baradaran, Nima</creatorcontrib><creatorcontrib>Fergus, Kirkpatrick B.</creatorcontrib><creatorcontrib>Moses, Rachel A.</creatorcontrib><creatorcontrib>Patel, Darshan P.</creatorcontrib><creatorcontrib>Gaither, Thomas W.</creatorcontrib><creatorcontrib>Voelzke, Bryan B.</creatorcontrib><creatorcontrib>Smith, Thomas G.</creatorcontrib><creatorcontrib>Erickson, Bradley A.</creatorcontrib><creatorcontrib>Elliott, Sean P.</creatorcontrib><creatorcontrib>Alsikafi, Nejd F.</creatorcontrib><creatorcontrib>Vanni, Alex J.</creatorcontrib><creatorcontrib>Buckley, Jill</creatorcontrib><creatorcontrib>Zhao, Lee C.</creatorcontrib><creatorcontrib>Myers, Jeremy B.</creatorcontrib><creatorcontrib>Breyer, Benjamin N.</creatorcontrib><title>Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)</title><title>World journal of urology</title><addtitle>World J Urol</addtitle><addtitle>World J Urol</addtitle><description>Purpose
To assess the functional Queryoutcome of patients with cystoscopic recurrence of stricture post-urethroplasty and to evaluate the role of cystoscopy as initial screening tool to predict future failure.
Methods
Cases with cystoscopy data after anterior urethroplasty in a multi-institutional database were retrospectively studied. Based on cystoscopic evaluation, performed within 3-months post-urethroplasty, patients were categorized as small-caliber (SC) stricture recurrence: stricture unable to be passed by standard cystoscope, large-caliber (LC) stricture accommodating a cystoscope, and no recurrence. We assessed the cumulative probability of intervention and the quality of life scores in association with cystoscopic recurrence 1-year post-urethroplasty. Patients with history of hypospadias, perineal urethrostomy, urethral fistula, and meatal pathology were excluded.
Results
From a total of 2630 men in our cohort, 1054 patients met the inclusion criteria: normal (
n
= 740), LC recurrence (
n
= 178), and SC recurrence (
n
= 136) based on the first cystoscopic evaluation performed at median 111 days postoperatively. Median follow-up was 350 days (IQR 121–617) after urethroplasty. Cystoscopic recurrence was significantly associated with secondary interventions (2.7%, 6.2%, 33.8% in normal, LC, and SC groups, respectively). Quality of life variables were not statistically significantly different among the three study groups.
Conclusions
Many patients with cystoscopic recurrence do not need an intervention after initial urethroplasty. Despite good negative predictive value, cystoscopy alone may be a poor screening test for stricture recurrence defined by patient symptoms and need for secondary interventions.</description><subject>Adult</subject><subject>Clinical significance</subject><subject>Cystoscopy</subject><subject>Fistulae</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Quality of life</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Self report</subject><subject>Stricture</subject><subject>Trauma</subject><subject>Urethra - surgery</subject><subject>Urethral Stricture - surgery</subject><subject>Urologic Surgical Procedures, Male - methods</subject><subject>Urology</subject><issn>0724-4983</issn><issn>1433-8726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1vEzEQhi0EoqHwBzggS1zKYcFfa-9yqyK-pKpIbXJeObPe4LK7DmMblJ_HP8NpAkgcuNgez_PO2PMS8pyz15wx8yYyJlVdMd5WTOhaVvoBWXAlZdUYoR-SBTNCVapt5Bl5EuMdY9xoVj8mZ5IZLljLF-TncvSzBzvS6LezH8pxBkfDQGEfU4gQdh5oRpe-4AFK6CGVkKKDjOgOsB2SQ2rnsvqAJzjsRhvT_i21dMpj8pWfY_IpJx_mwtpxH32kA4aJrtDmyZbLnq4xjGFbOt44CEWAGZL_7ui1Sz8Cfj286zbj1pUcvVitb65vXz0ljwY7RvfstJ-T9ft3q-XH6urzh0_Ly6sKFG9TpWqtjLJKSVdm0KtGiwak0aA19Bu7aWoAbo1WfauglhuwfaP7_jAzbpSo5Tm5ONbdYfiWXUzd5CO4cbSzCzl2gpu2LoOVoqAv_0HvQsby53tKtbzWghVKHCnAECO6oduhnyzuO866g8Hd0eCuGNzdG9zpInpxKp03k-v_SH47WgB5BGJJzVuHf3v_p-wv8dy1UQ</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Baradaran, Nima</creator><creator>Fergus, Kirkpatrick B.</creator><creator>Moses, Rachel A.</creator><creator>Patel, Darshan P.</creator><creator>Gaither, Thomas W.</creator><creator>Voelzke, Bryan B.</creator><creator>Smith, Thomas G.</creator><creator>Erickson, Bradley A.</creator><creator>Elliott, Sean P.</creator><creator>Alsikafi, Nejd F.</creator><creator>Vanni, Alex J.</creator><creator>Buckley, Jill</creator><creator>Zhao, Lee C.</creator><creator>Myers, Jeremy B.</creator><creator>Breyer, Benjamin N.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20191201</creationdate><title>Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)</title><author>Baradaran, Nima ; Fergus, Kirkpatrick B. ; Moses, Rachel A. ; Patel, Darshan P. ; Gaither, Thomas W. ; Voelzke, Bryan B. ; Smith, Thomas G. ; Erickson, Bradley A. ; Elliott, Sean P. ; Alsikafi, Nejd F. ; Vanni, Alex J. ; Buckley, Jill ; Zhao, Lee C. ; Myers, Jeremy B. ; Breyer, Benjamin N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-456474a443e605d48628c376c66cdbab85cc1a764d94c53bcad86dd0017174253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Clinical significance</topic><topic>Cystoscopy</topic><topic>Fistulae</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nephrology</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Quality of life</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Self report</topic><topic>Stricture</topic><topic>Trauma</topic><topic>Urethra - surgery</topic><topic>Urethral Stricture - surgery</topic><topic>Urologic Surgical Procedures, Male - methods</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baradaran, Nima</creatorcontrib><creatorcontrib>Fergus, Kirkpatrick B.</creatorcontrib><creatorcontrib>Moses, Rachel A.</creatorcontrib><creatorcontrib>Patel, Darshan P.</creatorcontrib><creatorcontrib>Gaither, Thomas W.</creatorcontrib><creatorcontrib>Voelzke, Bryan B.</creatorcontrib><creatorcontrib>Smith, Thomas G.</creatorcontrib><creatorcontrib>Erickson, Bradley A.</creatorcontrib><creatorcontrib>Elliott, Sean P.</creatorcontrib><creatorcontrib>Alsikafi, Nejd F.</creatorcontrib><creatorcontrib>Vanni, Alex J.</creatorcontrib><creatorcontrib>Buckley, Jill</creatorcontrib><creatorcontrib>Zhao, Lee C.</creatorcontrib><creatorcontrib>Myers, Jeremy B.</creatorcontrib><creatorcontrib>Breyer, Benjamin N.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baradaran, Nima</au><au>Fergus, Kirkpatrick B.</au><au>Moses, Rachel A.</au><au>Patel, Darshan P.</au><au>Gaither, Thomas W.</au><au>Voelzke, Bryan B.</au><au>Smith, Thomas G.</au><au>Erickson, Bradley A.</au><au>Elliott, Sean P.</au><au>Alsikafi, Nejd F.</au><au>Vanni, Alex J.</au><au>Buckley, Jill</au><au>Zhao, Lee C.</au><au>Myers, Jeremy B.</au><au>Breyer, Benjamin N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)</atitle><jtitle>World journal of urology</jtitle><stitle>World J Urol</stitle><addtitle>World J Urol</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>37</volume><issue>12</issue><spage>2763</spage><epage>2768</epage><pages>2763-2768</pages><issn>0724-4983</issn><eissn>1433-8726</eissn><abstract>Purpose
To assess the functional Queryoutcome of patients with cystoscopic recurrence of stricture post-urethroplasty and to evaluate the role of cystoscopy as initial screening tool to predict future failure.
Methods
Cases with cystoscopy data after anterior urethroplasty in a multi-institutional database were retrospectively studied. Based on cystoscopic evaluation, performed within 3-months post-urethroplasty, patients were categorized as small-caliber (SC) stricture recurrence: stricture unable to be passed by standard cystoscope, large-caliber (LC) stricture accommodating a cystoscope, and no recurrence. We assessed the cumulative probability of intervention and the quality of life scores in association with cystoscopic recurrence 1-year post-urethroplasty. Patients with history of hypospadias, perineal urethrostomy, urethral fistula, and meatal pathology were excluded.
Results
From a total of 2630 men in our cohort, 1054 patients met the inclusion criteria: normal (
n
= 740), LC recurrence (
n
= 178), and SC recurrence (
n
= 136) based on the first cystoscopic evaluation performed at median 111 days postoperatively. Median follow-up was 350 days (IQR 121–617) after urethroplasty. Cystoscopic recurrence was significantly associated with secondary interventions (2.7%, 6.2%, 33.8% in normal, LC, and SC groups, respectively). Quality of life variables were not statistically significantly different among the three study groups.
Conclusions
Many patients with cystoscopic recurrence do not need an intervention after initial urethroplasty. Despite good negative predictive value, cystoscopy alone may be a poor screening test for stricture recurrence defined by patient symptoms and need for secondary interventions.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30712091</pmid><doi>10.1007/s00345-019-02653-6</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; SpringerNature Journals |
subjects | Adult Clinical significance Cystoscopy Fistulae Humans Male Medicine Medicine & Public Health Middle Aged Nephrology Oncology Original Article Quality of life Recurrence Retrospective Studies Self report Stricture Trauma Urethra - surgery Urethral Stricture - surgery Urologic Surgical Procedures, Male - methods Urology |
title | Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS) |
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